Otolaryngology Coding Alert

Question: Our coding staff is having a disagreement regarding the proper code to use when cauterization/ablation of inferior turbinate is performed. Can you advise the proper CPT code to use when the surgeon states that the procedure performed is "bilateral submucous resection of inferior turbinates."

The procedure was done using the Coblator and submucosal resection tunnels were created; good volumetric reduction was achieved. The turbinates were then therapeutically outfractured. Is 30802 or 30140 correct?

Florida Subscriber

Answer: The correct code for what you describe is 30802 (Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method [e.g., electrocautery, radiofrequency ablation, or tissue volume reduction]; intramural [i.e., submucosal]).

CPT 2010 changed the terminology for 30802 to include radiofrequency ablation. Code 30140 (Submucous  resection inferior turbinate, partial or complete, any method) is instead for an inferior turbinoplasty, which is done surgically, not through destruction.

Code 30802 describes the destruction of the mucosa from within the nose. The physician uses various methods/techniques like cautery, ablation, coblation, or somnoplasty of the superficial area of inferior turbinates. In a bipolar cautery, a needle is inserted into the inferior turbinates and a controlled current is passed into the turbinates to cauterize or shrink the tissue. Other techniques, like the use of lasers or radiofrequency (RFA), can also be used to perform this procedure.